HEPA Filtration on Reducing Cardiometabolic Risk During Wildfires

摘要 在这项补充研究中，我们建议调查气候变化对健康的影响，重点是 论野地火灾强化的空气污染对人类健康的影响。补充研究的基础将是 正在进行的SAPIA研究“通过室内空气过滤减缓动脉血栓形成的进展”，旨在 评估高效空气过滤器在减少室内PM2.5暴露方面的有效性以及随后对 改善动脉粥样硬化血栓形成的结果。SAPIA研究将招募52名年龄在65岁至84岁的参与者并对其进行跟踪调查 20岁，有缺血性心脏病病史，2023-2024年居住在洛杉矶地区。的目标是 这项补充研究将扩展SAPIA最初的目标，重点是调查野火的不利影响 暴露和评估住宅高效空气过滤器在1)减少室内PM2.5暴露方面的有效性 在野火事件期间，以及2)减轻野火对急性心血管后果的不良影响 (血压、心率变异性和生物标志物)。我们将利用现有的国家和地区的野火和空气 建立污染监测网络，监测野火季节(5月至9月)期间的野火事件。我们会 在参与者的住处安装低成本的空气质量传感器，监测室内外PM2.5 级别。通过使用时间序列和扩散模型，我们将验证野火的室内和室外水平- 派生出HEPA和非HEPA设置下的PM2.5。这一方法将使我们能够评估 高效空气过滤器在降低室内PM2.5浓度中的作用。一旦确定了野火事件，参与者将被 通知填写问卷，并采用预分发和自我收集的方式收集尿样和血样 检测试剂盒。每日血压(BP)和心率变异性将使用BP监护仪远程收集 以及可穿戴的Oura®戒指。这项研究的优点包括使用双臂随机试验嵌套试验 在正在进行的SAPIA交叉试验中，用于实时健康监测的可穿戴数字设备和自我 采集血液和尿液样本，从而能够评估野火对健康的严重影响。 这项研究的结果将有助于评估HEPA过滤作为预防不良反应的工具的有效性 野火引起的空气污染暴露对健康的影响。总之，这项补充研究将有助于 对于了解气候变化增强的野火对人类健康的影响和潜在的 通过减少暴露在野火产生的PM2.5中，高效空气过滤器对健康的好处。通过将最新的- ART暴露评估方法、实时健康结果监测和生物样本自我收集，这 这项研究将对野火造成的空气污染和 心血管健康，为这一领域未来更大规模的研究铺平了道路。

ABSTRACT In this supplemental study, we propose to investigate the climate change effects on health, focusing specifically on the impact of wildland fire-enhanced air pollution on human health. The supplemental study will be built upon the ongoing SAPIA study, "Slowing Atherothrombosis Progression through Indoor Air Filtration," aiming to assess the effectiveness of HEPA filtration in reducing indoor PM2.5 exposure and the subsequent effects on improving atherothrombosis outcomes. The SAPIA study will enroll and follow up 52 participants aged 65-84 years old with ischemic heart disease history and living in the Los Angeles area in year 2023-2024. The aims of this supplemental study will extend the original SAPIA aims to focus on investigating adverse effects of wildfire exposures and assess the effectiveness of residential HEPA filtration in 1) reducing indoor exposure to PM2.5 during wildfire events and 2) alleviating the wildfire-induced adverse effects on acute cardiovascular outcomes (blood pressure, heart rate variability and biomarkers). We will use existing national and regional wildfire and air pollution monitoring networks to monitor wildfire events during the wildfire season (May-September). We will employ low-cost air quality sensors at participants' residential addresses to monitor indoor and outdoor PM2.5 levels. By using both time-series and dispersion models, we will validate the indoor and outdoor levels of wildfire- derived PM2.5 in both HEPA and non-HEPA settings. This approach will enable us to assess the effectiveness of HEPA filtration in reducing indoor PM2.5 concentrations. Once a wildfire event is identified, participants will be informed to complete questionnaires and collect urine and blood samples using pre-distributed and self-collection test kits. Daily blood pressure (BP) and heart rate variability will be remotely collected using Withings BP monitors and wearable Oura® rings. The advantages of this study include the use of a two-arm randomized trial nested within the ongoing SAPIA cross-over trial, wearable digital devices for real-time health monitoring, and self- collection of blood and urine samples, which enable the assessment of the acute health effects of wildfires. Findings of this study will help to assess the effectiveness of HEPA filtration as a preventive tool for the adverse health effects of wildfire-originated air pollution exposure. In conclusion, this supplemental study will contribute significantly to understanding the impact of climate change-enhanced wildfires on human health and the potential health benefits of HEPA filtration by reducing exposure to wildfire-originated PM2.5. By combining state-of-the- art exposure assessment methods, real-time health outcome monitoring and self-collection of biosamples, this study will provide valuable insights into the relationship between wildfire-originated air pollution and cardiovascular health, paving the way for future larger-scale studies in this field.